The issue of doctor shaming

It’s terribly hard to be a doctor in this day and age. I don’t think people realize how understaffed our hospitals are. There are not enough doctors and nurses to tend to the number of patients getting sick daily. And this is taking a toll on everyone, most especially the healthcare team.

In the last few months, photos and videos have been taken in hospitals nationwide and posted indiscriminately online without consent or disclaimer. The typical unauthorized photo or video concerns a patient’s or watcher’s unfortunate experience with health personnel. “Likes” and comments are generated, mostly ranging from insulting to downright libelous.

The objective is to garner as much public sympathy as possible, as these issues are brought up and expected to be resolved in social media.

Meanwhile, members of the medical community are either losing passion for their vocation or quick to defend their colleagues with a consensus on the need to protect physicians and other healthcare workers on the job. One says it is unfair to take videos and photos of medical personnel on duty without their express permission, considering that all patients are asked to give their written consent only after physicians explain to them what to expect in the proposed treatment. In case presentations, faces are blurred to ensure confidentiality and privacy. A clear-cut line, with prescribed rules on confidentiality and privacy, is in place to protect patients, but none to protect doctors.

I surmise that doctor shaming became popular because social media has provided a platform for people wanting to be noticed. Filipinos have realized that it is much easier to be heard when grievances are raised to an exponential audience on Facebook. There is also the anonymity and disconnection from the objects of these rants, so the usual consideration of the implications of their actions and words is lost and they are empowered to be more adversarial.

Viral posts remind doctors that high-handed behavior when dealing with patients has negative repercussions. Indeed, doctors owe patients diligence and respect regardless of the latter’s social status, gender, or personal beliefs.

But what can doctors do when needs arise and options are limited? Definitely, arguing with a patient’s irate relatives has never benefited any doctor or other medical personnel. The most viable options are to calmly talk to the patient, call one’s superiors, or, if things escalate, seek help from the hospital’s legal and human resource departments. But when a doctor is exhausted after being on duty for more than 24 hours, these options prove to be arduous.

Gaining a patient’s trust is a challenge, too. If there is no rapport established between doctor and patient (as often happens due to the limited time spent per patient), misunderstandings occur and tempers rise, leading to rash behaviors like social media bullying.

A common ground between doctors and patients is the desire for expedient service, polite medical and nursing personnel, and an environment conducive to the restoration of health. All of us want the best healthcare possible for ourselves and our families.

But doctor shaming is rapidly getting out of hand.

The sacrifices that medical personnel make are quite easy to miss, partly because patients and their families do not see the entirety of a doctor’s daily schedule or the years he or she spent to become a doctor, and partly because of the pain, anxiety, or grief that a patient is experiencing. But it must be said that doctors are often overworked (24-to-36-hour shifts) and underpaid, and that interns are almost always exhausted from tending to a number of patients way beyond their capacity as human beings to handle.

A common misconception about physicians and interns (the most common target of cyberbullying) is that they are in the medical profession only because of the money. This is very far from reality. Resident physicians are paid a fixed salary per month. They have to work for 36 hours straight every other day, with no weekends or holidays to speak of. Medical interns’ compensation range from free meals to P10,000 per month. They work the same number of hours, tending to the same number of patients per day, sacrificing time for self and family, rest and sleep, and even food, to serve and acquire the necessary skills for their current and future patients.

For as long as the ratio between medical personnel and patients remain inhumane in our institutions, we cannot expect perfect care for our patients even if that is what we all want.

Former Miss Universe Pia Wurtzbach’s advice, “Think before you click,” is very apt for this situation because so far, none of these doctor-shaming posts has ever led to a change in the system and a resolution of the problems at hand. As it happens, doctors are pushed to be defensive and patients and their families are tagged as arrogant. The strain in doctor-patient relationships has only become pronounced, leading to the deterioration of healthcare.

Most issues can be resolved if patients channel their concerns to the proper venue. It is unfortunate that people feel the need to air concerns through their phones, take unauthorized photos and videos which often fail to capture the whole story, and complain online, when the most direct solution would have been to call the attention of the doctor or intern involved, or lodge a formal complaint with hospital management. Contrary to common belief, incidents, whether minor or major, get reviewed and investigated in hospitals, with corresponding sanctions meted out.

The effects of social media posts do not promote good medical practice. What they do is foster distrust among patients and increase stress among doctors because, aside from the demands of patient care, they have to contend with protecting themselves from being victims of cyberbullying.

A wider perspective on this issue of doctor shaming will bring us to the longstanding inadequate healthcare system, which is more pronounced in the public setting. While patients’ concerns are usually valid, their demands are not always realistic especially because all hospitals nowadays are short of healthcare workers.

Doctor shaming is a trend that we can expect to continue as long as our healthcare system is far from ideal. Doctors and nurses are most vulnerable because they are the most visible members of the healthcare team. We must challenge ourselves to see beyond the visible and provide constructive criticism and feedback regarding the unseen bigger problem: our healthcare system.

Faye Sinoy Travilla, MD, 24 is a graduate of University of the Philippines Manila and is affiliated with a local tertiary hospital.